Expert advice

Medicines management: Should I still advise patients to finish a course of antibiotics?

Despite a call from experts for patients to stop taking antibiotics when they feel better, nurses should still advise patients to complete the course of treatment, says medicines management expert Matt Griffiths.
antibiotics

Despite a call from experts for patients to stop taking antibiotics when they feel better, nurses should still advise patients to complete the course of treatment, says medicines management expert Matt Griffiths

In a recent article in the British Medical Journal (BMJ), a respected group of experts including infectious disease specialists and microbiologists discussed whether patients should stop taking antibiotics when they feel better.

They argued there is little evidence that failing to complete a prescribed course of antibiotics contributes to antimicrobial resistance, and advice to complete the course should be dropped.

This caused some controversy, as it contradicts the advice health professionals give to patients backed by the World Health Organization to complete the entire course of prescribed antibiotics.

Need for caution

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Despite a call from experts for patients to stop taking antibiotics when they feel better, nurses should still advise patients to complete the course of treatment, says medicines management expert Matt Griffiths

antibiotics
More research is needed on optimising the duration of antibiotic treatments.
 Picture: iStock

In a recent article in the British Medical Journal (BMJ), a respected group of experts including infectious disease specialists and microbiologists discussed whether patients should stop taking antibiotics when they feel better. 

They argued there is little evidence that failing to complete a prescribed course of antibiotics contributes to antimicrobial resistance, and advice to complete the course should be dropped. 

This caused some controversy, as it contradicts the advice health professionals give to patients – backed by the World Health Organization – to complete the entire course of prescribed antibiotics.

Need for caution

Although the BMJ article was based on results of randomised clinical trials and observational cohort studies, we still need to be cautious about changing current advice on the basis of one paper. 

In future, we may be able to tailor antibiotic use to specific patient needs and better monitor how infections are clearing up, but we are not there yet. 

If patients stop taking antibiotics based on this research and then new research shows this is not the best course of action, the advice would have to be changed back again, which would cause confusion among the public and could create public health issues.

More research

Antibiotic resistance is becoming a major problem worldwide, and it is true that the way we prescribe and use antibiotics has to change. Antibiotics are also a finite resource, and this paper certainly highlights a potential way forward to reduce antibiotic resistance. 

However, as the authors of the paper recognise, more research involving clinical trials is needed to determine the most effective strategies for optimising the duration of antibiotic treatments, and it is essential that funding is found for such research. 

In the meantime, healthcare staff should continue with the advice we are currently giving, which is to finish the whole course of antibiotics. Anything else would give patients mixed messages and cause confusion among the public. 


Matt Griffiths is visiting professor of prescribing and medicines management at Birmingham City University 

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